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[IPp] diluting the insulin

Natalie -

We use U25 Humalog insulin for our daughter Sigrid (she'll have her 
second birthday this week).  Yes, one unit of insulin brings her blood 
sugar down by 400 points.  Yes, the Cozmo doesn't accept the 
insulin/carb ratios or correction ratios she really needs (hopefully 
they will fix this on an upgrade?)  Diluting allows us to use the 
calculation features of the Cozmo (though we do have to lie to the pump 
- which is fine as long as we're consistent about it).  Yes, our 
endo/CDE didn't encourage this.  But this is what works for her; what 
they suggested did not work.

We dilute the insulin ourselves, since our pharmacist doesn't have a 
sterile hood to do this in.  Usually my husband does this at his lab, 
but I have done it in our dining room, too, with no ill results.  You 
can ask your pharmacist (any pharmacist) to call Lilly's Diluent 
Ordering Department and they will send diluent and sterile mixing 
bottles FREE to the pharmacist (they won't send it to patients).  To 
mix, you will need syringes which you can buy over the counter.  Just 
set up a system so that you don't get mixed up with what is what (as 
you're diluting U50, this isn't much of an issue; you're putting in 
equal volumes of insulin versus diluent).

Keep careful records of what insulin Andrea gets, how much carbs she 
eats, and what her blood sugars are.  While you will want to discuss 
these with your CDE/endo, they may not really spend as much time on 
deciphering the data as they should, and they may be overly concerned 
with sticking to "rules" when your daughter's actual data doesn't match 
the rules.  If we listened to our endo, we would be giving Sigrid about 
twice the basal insulin she gets (to match the 40-50% "rule") - and we 
would be stuffing jelly into her to fight lows EVERY DAY.  "Rules" are 
a starting point, but your daughter's actual results are a much more 
important guide.

We'd be happy to go on in greater detail about this if you want - email 
me offline.

- Maria Oyaski
mom to Sigrid, dx'd @11 mos., pumping w/Cozmo since 17 mos., will be 2 
this week!
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